This is a proposal for a three-year program of research and career development. Over the course of the program the principal investigator will begin to establish herself as a behavioral medicine intervention researcher while conducting a randomized, controlled, treatment trial for adults with somatization disorder. The proposal is the initial step in the principal investigator's long-term pursuit to develop effective treatments for this refractory problem. The intervention trial aims to assess the efficacy of a 10- session cognitive behavior therapy (CBT) manual for patients with somatization disorder, a problem characterized by numerous medically unexplained physical symptoms. Seventy-two patients will be randomly assigned to either the CBT condition or the control comparison condition, standard medical care. All 72 patients will be evaluated by a blind rater and with self-report questionnaires at four points during the study, i.e., pretreatment, post-treatment, six months post-treatment, and twelve months post-treatment. It is hypothesized that patients who receive CBT will report greater reductions in disability and in severity of somatic complaints than the patients in the control condition at all three post-treatment evaluations. Also, CBT patients are expected to have a greater reduction in health care expenditures over the year following treatment than will control patients. Finally, preliminary exploratory analyses will be conducted to examine whether certain cognitive characteristics of somatizers predict their treatment response. The career development plan is designed to assist the principal investigator in (1) augmenting her knowledge of somatoform disorders, behavioral medicine, and health psychology, and (2) refining her skills in stress management, medical cost analysis, data analysis, and the proper conduct of clinical intervention trials. The knowledge and skills will be acquired through course work, independent study, research meetings and discussions with consultants. The multidisciplinary team of sponsors, consultants, and colleagues will broaden the scope of both the research project and the principal investigator's intellectual development.